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Arch Dis Child. 1999 Mar;80(3):257-61. doi: 10.1136/adc.80.3.257.

A search for the evidence supporting community paediatric practice.

Archives of disease in childhood

T Bennett, S Bosson, A Bundle, V Cove, D Damman, M Garner, P Guest, V Kaur, A Kelly, M Khan, N Lyth, G Rowland, M C Rudolf, R Thazin

Affiliations

  1. Academic Unit of Paediatrics and Child Health, University of Leeds, UK.

PMID: 10325707 PMCID: PMC1717855 DOI: 10.1136/adc.80.3.257
Free PMC Article

Abstract

AIM: Controversy exists regarding the evidence base of medicine. Estimates range from 20% to 80% in various specialties, but there have been no studies in paediatrics. The aim of this study was to ascertain the evidence base for community paediatrics.

METHODS: Twelve community paediatricians working in clinics and schools in Yorkshire, Manchester, Teesside, and Cheshire carried out a prospective review of consecutive clinical contacts. Evidence for diagnostic processes, prescribing, referrals, counselling/advice, and child health promotion was found by searching electronic databases. This information was critically appraised and a consensus was obtained regarding quality and whether it supported actions taken.

RESULTS: Two hundred and forty-seven consultations and 1149 clinical actions were performed. Good evidence was found from a randomised controlled trial or other appropriate study for 39.9% of the 629 actions studied; convincing non-experimental evidence for 7%; inconclusive evidence for 25.4%; evidence of ineffectiveness for 0.2%; and no evidence for 27.5%. Prescribing and child health promotion activities had the highest levels of quality evidence, and counselling/advice had the lowest.

CONCLUSIONS: An encouraging amount of evidence was found to support much of community paediatric practice. This study improved on previous research in other specialties because actions other than medications and surgery were included.

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References

  1. Br Med J. 1979 Mar 31;1(6167):854-7 - PubMed
  2. N Engl J Med. 1998 Oct 15;339(16):1112-20 - PubMed
  3. Br J Urol. 1985 Aug;57(4):474-7 - PubMed
  4. Arch Dis Child. 1985 Dec;60(12):1122-7 - PubMed
  5. Br J Urol. 1988 Feb;61(2):146-7 - PubMed
  6. BMJ. 1988 Jul 16;297(6642):163-6 - PubMed
  7. Vaccine. 1989 Aug;7(4):300-2 - PubMed
  8. Clin Otolaryngol Allied Sci. 1991 Apr;16(2):157-9 - PubMed
  9. Lancet. 1992 Feb 29;339(8792):507-10 - PubMed
  10. BMJ. 1992 Nov 7;305(6862):1134-6 - PubMed
  11. BMJ. 1992 Dec 5;305(6866):1400-2 - PubMed
  12. Arch Dis Child. 1993 Sep;69(3):361-5 - PubMed
  13. Pediatr Allergy Immunol. 1993 Aug;4(3):152-6 - PubMed
  14. JAMA. 1993 Dec 1;270(21):2598-601 - PubMed
  15. JAMA. 1994 Mar 2;271(9):703-7 - PubMed
  16. Dev Med Child Neurol. 1994 Jun;36(6):484-6 - PubMed
  17. Arch Dis Child. 1993 Jul;69(1):125-9 - PubMed
  18. JAMA. 1994 Nov 2;272(17):1367-71 - PubMed
  19. N Engl J Med. 1994 Nov 24;331(21):1397-402 - PubMed
  20. JAMA. 1995 Apr 26;273(16):1292-5 - PubMed
  21. Arch Dis Child. 1995 Mar;72(3):230-2 - PubMed
  22. JAMA. 1995 May 24-31;273(20):1610-3 - PubMed
  23. Lancet. 1995 Aug 12;346(8972):407-10 - PubMed
  24. BMJ. 1995 Aug 19;311(7003):485 - PubMed
  25. Vaccine. 1995 Nov;13(16):1617-22 - PubMed
  26. BMJ. 1996 Mar 30;312(7034):819-21 - PubMed
  27. Lancet. 1996 Mar 16;347(9003):709-13 - PubMed
  28. J Bone Joint Surg Am. 1996 Mar;78(3):383-8 - PubMed
  29. J Am Acad Child Adolesc Psychiatry. 1996 Apr;35(4):409-32 - PubMed
  30. Arch Dis Child. 1996 Oct;75(4):298-303 - PubMed
  31. Arch Dis Child. 1997 Jan;76(1):50-3 - PubMed
  32. Arch Dis Child. 1997 Apr;76(4):381-4 - PubMed
  33. BMJ. 1998 May 16;316(7143):1535-6 - PubMed
  34. Am J Dis Child. 1985 Jun;139(6):636-9 - PubMed

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